A cardiologist is a heart doctor, and they know all there is to know about the anatomy of the human heart. Living in Miami or Coral Gables or anywhere else doesn’t matter when it comes to coronary heart disease. Call Dr. Bordenave for a consultation and see how integrative medicine can help you be healthier.
When your doctor wants to check the function of your heart, he will use an electrocardiogram and often an echocardiogram to measure how your heart is working.
I have read the AHA/ACC Statin Guidelines, as well as many of the tidal wave of articles printed both for and against the new recommendations, most written by equally respected expert physicians.
Is it just me or has something drastically changed with the practice of medicine in the U.S.?
I realize that medicine has transitioned from a most noble profession to a business, but it is mind boggling to notice such a wide diversity of expert opinions that differ and contradict each other. Most of those in favor of the new recommendations are cardiologists. After all, the American College of Cardiology and American Heart Association put out the recommendations. One prominent cardiologist even wrote he was surprised at the standard therapy for those 75 or older, with no statin recommendation for primary prevention in the elderly. Others, including the American Association of Clinical Endocrinologists, are so opposed to the new guidelines, that they will not endorse or follow the new recommendations.
If this isn’t concerning enough, two months later, the new BP Guidelines from JNC-8 were released. Raising of target BP to a systolic of 150mmHg and the elimination of previous target systolic pressure of 130mmHg in diabetics and those with chronic kidney disease. Most controversial and embarrassing still, was the defection of 5 of the 14 members that formed the panel, each of whom came out in opposition to the conclusions after its release.
Let’s forget about the methodology used to create the guideline. Forget about the recommendations, and forget about the reasons why so many experts are in disagreement. What I see as the real issue is a complete shift in what is important to us as physicians.
It seems that there is an obsession with guidelines. We have so many guidelines that there is a guidelines clearinghouse to store them. There is also concern with the way guidelines are developed. A process with little or no transparency, made up of experts from a diverse body of special interests whose goal it seems is self-promotion for himself or herself or the organization they represent.
As a practicing physician, I am guide-lined to death. What’s worse is that very few physicians individualize the recommendations as they should, instead applying them equally to all patients, in a “one size fits all” model.
A serious problem arises for all of us when the recommendations by one medical group are not recognized or accepted by another medical group.
When there is disagreement and opposition among the members of the guideline panel that releases recommendations anyway, then in my opinion we have a severely damaged and broken system.
We have experts that can’t agree on much and the patients and physicians who don’t know what to believe in or who to trust.
“First do no harm.” Maybe guideline panel members should continuously remind themselves of that phrase while they are formulating new guidelines.
It seems that in medicine there are too many “experts” giving too many recommendations that only cause confusion. It’s a disservice to patients and physicians. It needs to stop before we loose what little credibility we have left as physicians.
Science fails medicine not through lack of competence, but through lack of vision. Not for the lack of curiosity, but for the limit of things we are curious about. Not for the lack in the ability to investigate, but for the narrowness of the scope of things it is willing to investigate.
I am still waiting for the day that guidelines are published, that deal with the cause of chronic disease instead of the treatment. When all medical organizations, health groups and wellness stakeholders can unite in agreement demanding better quality and a more affordable food supply for the entire U.S. population. We need to start subsidizing organic produce and farming, stop the routine use of antibiotics and hormones in livestock, limit chemicals in our foods and improving the water supply. We should have nutrition education that starts in elementary school and we should begin reinstating physical education periods. This is what is needed, not more guidelines that push more drugs on a country overdosing in drugs.
This isn’t being an idealist, this is being a responsible physician.
Despite all the guidelines published and the increased use of statins, we spend $60 billion a week in healthcare and all we have to show for it is being in 46th position in healthcare outcomes and quality, behind Iran and ahead of Serbia.
Maybe its time we remember to put patients ahead of other interests.
This article has been written by:
Jorge Bordenave MD FACP ABIHM
Integrative Cardiologist
Miami Integrative Medicine
Dr. Jorge Bordenave was born in Havana, Cuba and moved with his physician father and educator mother to Miami, Florida when he was an infant. Being a medical doctor seems to run in his family, as his grandfather was also a physician.
First Focus
Dr. Bordenave’s first focus was internal medicine and he spent his medical internship in the Bronx, New York, at St. Barnabas Hospital. St. Barnabas is a teaching hospital and Dr. Bordenave was exposed to a wide range of medical conditions and diseases. This is where he first developed a strong interest in cardiovascular disease. He relocated to Chicago to complete his residency in general internal medicine.
Throughout his residency, his interest in cardiology grew and when it was completed, he applied to Mt. Sinai Medical Center in Miami Beach for a three-year cardiology fellowship.
Cardiology
His application to Mt. Sinai’s cardiology fellowship was accepted and he went on to become proficient at a great number of cardiac procedures such as cardiac catheterization and transesophageal echocardiography. He had a keen interest in new technology and began to learn about nuclear cardiology. This new method of diagnosis was non-invasive and involves the use of radioactive elements that show where blood is flowing through the heart and more importantly, where it was not, or where blood flow was restricted. Dr. Bordenave was on the ground floor of the use of this new method and was among the first cardiologists in South Florida to start using the practice in the field.
After several years in private practice as a clinical cardiologist and having performed hundreds of cardiac catheterizations, Dr. Bordenave realized that he was seeing younger and younger patients. He noticed a growing dependence on drugs, testing and invasive procedures. He decided to stop performing invasive procedures in his practice and wanted to find alternative treatments for helping his patients. With a mind toward holistic medicine, he took up another fellowship, this time in Integrative Medicine at the University of Arizona under Dr. Andrew Weil.
Focus on Integrative Medicine
While at the University of Arizona, Dr. Bordenave became reacquainted with the belief that the body has a natural ability to cure itself. His training and continued learning has placed him as a leader in preventative medicine in south Florida.
As a teacher at Florida International University, sought after lecturer and author, Dr. Bordenave is passing on his passion for patient’s health and wellness through teaching other medical professionals the benefits of integrative, complementary medicine.
Connecting with the Hispanic Community
Dr. Bordenave is well known throughout the south Florida communities in which he serves, but he places a special focus on the Hispanic community.
The doctor presents weekly television and radio programs in Spanish that features experts and advice from other fields that provide information on a wide range of medically related topics. Dr. Bordenave and Your Health is geared toward giving the Hispanic community the kind of information that they might not normally have access to; information that can help them live healthier lives.
Dr. Bordenave provides information in Spanish about obtaining a healthy body and mind through the use of proper nutrition, exercise and a peaceful mind. The information he provides cover subjects as diverse as coronary artery disease; Tai Chi for arthritis, diabetes, back pain and osteoporosis; meditation; depression; sleep apnea and insomnia; kidney disease; acupuncture and of course, nutrition for optimum health. He also puts out a Spanish language monthly magazine, Su Salud.
His outreach doesn’t stop at health, wellness and medicine. In addition, Dr. Bordenave provides information to Spanish speakers regarding Medicare and now, The Patient Protection and Affordable Care Act, better known as Obamacare. The information and resources he provides is invaluable to the Hispanic community.
As a leader in preventative and integrative medicine, Dr. Jorge Bordenave has been serving south Florida from his Coral Gables location since 1996. He has a sincere interest in patient health and wellness and teaching the Hispanic community how to obtain these through lifestyle choices, diet and exercise. Contact him today for an appointment and learn how the integrative medicine approach can help you achieve wellness.
Published by Axiom Health Care Marketing
The cooler weather often brings arthritis aches and pains. Dr. Jorge Bordenave at Miami Integrative Medicine can show you natural remedies and exercises to help relieve the effects of this sometimes-debilitating disease. Give us a call today.
Dr. Jorge Bordenave and all of his staff want to wish you and your family the best of Thanksgivings as we each gather together with our friends and family to give thanks for all of our blessings.
Thanksgiving brings a veritable cornucopia of foods to the dining table. However, that doesn’t mean that the celebration means that you have to eat unhealthy foods. Dr. Bordenave suggests making good food choices and staying away from fatty, heavy foods and those with little nutritional value. Take a look at our November newsletter; we hope you will enjoy reading it.
So you’ve researched it, mulled it over and are now ready to make some major changes in your life. You’ve decided that integrative medicine is going to be a critical part of making such changes. Now what? If you’re stumped, this article covers everything you need to know to prepare for your first appointment.
The staff at Miami Integrative Medicine would like to wish everyone Happy Holidays, Merry Christmas and a Happy New Year!
Website: www.miamiintegrativemedicine.com
Posted by Axiom Administrative Services
AXIOM CORPORATE INFORMATION 69 Appaloosa Lane, Bldg C, Ste. 201 Ormond Beach, Florida 32174 Phone/Fax: 800-888-6348 Website: www.axiomadminserv.com Integrated Healthcare Marketing Services
When you decide to visit an Integrative Medicine practitioner for your initial appointment, there are some steps that you must take before the visit to make it go smoother and get better results. Your initial visit to the Integrative Medicine practitioner will cover everything necessary to establish a baseline for your Integrative Medicine treatment. Once your first visit is completed, your Integrative Medicine practitioner(s) will then analyze your medical records and information gathered from speaking with you during the visit to determine a health care plan for future visits. Your initial visit to the Integrative Medicine practitioner’s office is highly important and has many implications for the rest of your treatment for current and future medical needs.
Before you see your Integrative medical practitioner in person, there are some important and necessary steps to complete. Speak with all doctors, hospitals and related medical professionals to obtain medical records (lab reports, doctor’s notes, prescriptions records, etc.). You will need to document your personal and genetic history of diseases, chronic health conditions, etc. Along with your prescription medical records that your current practitioners have prescribed for you, you should document all supplements and herbs that you take and for what reason. Documenting what your currently ingest is good to let your Integrative Medicine practitioner understand what you are taking and to double check your medical records. Ideally, supplying as much of this as possible before your initial visit is ideal because your Integrative Medicine practitioner can review your records and personal information and ask any necessary investigatory questions.
The next step is to attend your appointment at your Integrative Medicine practitioner’s office. During your first visit, your doctor will follow up and complete their comprehensive review of your baseline health. He or she will speak with you to confirm all of the important details of your medical history – this includes surgeries, past and present major medical conditions, you and your family’s genetic past and any present issues that you are facing. Without establishing your baseline health and any existing chronic or acute health conditions, your doctor will not be able to effectively and efficiently treat you and make appropriate recommendations for your prescriptions, supplements and diet.
After performing a physical evaluation, your Integrative Medicine practitioner will evaluate your diet, supplement and exercise regimen. Based on your current health, diet, supplement regimen and exercise regimen, your Integrative Medicine practitioner will make recommendations based on each factor. Your Integrative Health medicine practitioner may also write prescriptions for the appropriate medication to treat your disease(s) along with modifying your lifestyle choices as well as your nutrition and supplement regimen. Determining your baseline health, along with what your current nutrition and supplement regimen is essential to help your Integrative Medicine practitioner customize your individual treatment program.
After your first visit your Integrative Medicine practitioner will take some time on his or her own to develop a comprehensive or “integrative” approach to your health maintenance plan. Normally, it requires no additional time or interaction with your Integrative Medicine practitioner, unless you want to supply additional medical records. This approach will analyze and synthesize all of the information your doctor has to date on you, your medical records, what you say during the visit and what other physician’s offices might add beyond your medical records. This process will then culminate into a detailed and personalized healthcare plan based on an “Integrative Medicine” approach. You will then have one or many follow-up visits depending on your current health, what you want to accomplish and what you Integrative Medicine practitioner feels is necessary to optimizing your health.
Website: www.miamiintegrativemedicine.com
Posted by Axiom Administrative Services
AXIOM CORPORATE INFORMATION 69 Appaloosa Lane, Bldg C, Ste. 201 Ormond Beach, Florida 32174 Phone/Fax: 800-888-6348 Website: www.axiomadminserv.com Integrated Healthcare Marketing Services